Watterson Taylor L, Moon Jukrin, Stone Jamie A, Gilson Aaron M, Berbakov Maria E, Hoffins Emily L, Chladek Jason S, Lehnbom Elin C, Resendiz Stephanie M, Mai Shiying, Walker Kenneth D, Gollhardt Joel D, Chui Michelle A
Pharmacy Systems Outcomes and Policy, College of Pharmacy, University of Illinois Chicago, USA.
Department of Industrial and Systems Engineering, University of Iowa, USA.
Explor Res Clin Soc Pharm. 2024 Aug 5;15:100486. doi: 10.1016/j.rcsop.2024.100486. eCollection 2024 Sep.
Community pharmacies, as unique and accessible healthcare venues, are ideal locations to implement interventions aiming to improve patient care. However, these interventions may increase workload or disrupt workflow for community pharmacists, technicians, and other staff members, threatening long-term sustainment. There are growing calls from the field of implementation science to design for intervention sustainment and maintenance by maximizing innovation fit. Senior Safe™, an intervention to facilitate safer over-the-counter (OTC) product selection by older adults, serves as a case study to examine the congruence between Innovation Factors and community pharmacy Inner Context constructs and their implications for workload and sustainment.
Using the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, this qualitative study identified factors surrounding Senior Safe implementation. Semi-structured interviews were conducted with staff from pharmacies where Senior Safe was implemented. Two coders independently analyzed interview transcripts using deductive analysis based on EPIS constructs. Thematic analysis was used to generate three themes that encapsulated innovation fit.
Nineteen pharmacy staff members participated, with the majority reporting no significant change in their workload or workflow due to Senior Safe. Interview feedback supported a pre-existing culture of the healthcare system to engage patients, of leadership commitment to patient safety initiatives, and of an amplified role of pharmacy technicians.
Pharmacy staff interviews revealed congruence between Innovation Factors and Inner Context that likely yielded intervention workload neutrality. This study highlighted the importance for researchers to consider maintenance and sustainability when designing and implementing an intervention and the critical influence of culture and leadership support during this process.
社区药房作为独特且便捷的医疗保健场所，是实施旨在改善患者护理的干预措施的理想地点。然而，这些干预措施可能会增加社区药剂师、技术人员和其他工作人员的工作量或扰乱工作流程，从而威胁到长期可持续性。实施科学领域越来越多地呼吁通过最大化创新契合度来设计干预措施的维持和持续。高级安全（Senior Safe™）是一项旨在帮助老年人更安全地选择非处方（OTC）产品的干预措施，作为一个案例研究，以检验创新因素与社区药房内部环境构建之间的一致性及其对工作量和可持续性的影响。
本定性研究使用探索、准备、实施、维持（EPIS）框架，确定了围绕高级安全实施的因素。对实施高级安全的药房工作人员进行了半结构化访谈。两名编码员使用基于EPIS构建的演绎分析方法独立分析访谈记录。采用主题分析法生成了三个概括创新契合度的主题。
19名药房工作人员参与了研究，大多数人报告称由于高级安全措施，他们的工作量或工作流程没有显著变化。访谈反馈支持了医疗保健系统中预先存在的让患者参与的文化、领导层对患者安全倡议的承诺以及药房技术人员角色的扩大。
药房工作人员访谈揭示了创新因素与内部环境之间的一致性，这可能导致干预措施对工作量的影响保持中性。本研究强调了研究人员在设计和实施干预措施时考虑维持和可持续性的重要性，以及在此过程中文化和领导层支持的关键影响。
